LELAND DAVID PETERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047017274

License Status

NOT RENEWED

Business

First Name

LELAND

Middle

DAVID

Last Name

PETERSON

Suffix

Business Name

LELAND DAVID PETERSON OD

Original Issue Date

04/06/1996

Expiration Date

03/31/1998

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/01/2005